Individual provider Active NPI

Randall Scott Friese, MD

  • Trauma Surgery Physician
  • Dallas, TX
National Provider Identifier
1104886357
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
L2258 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone
(214) 648-3067
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X L2258 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 648-3067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080715000452 AZ Practitioner - General SurgeryPractitioner - Other (Physician) 4587737176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Maryland School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

2800 E Ajo Way
Tucson, AZ 85713-6204

535 N Wilmot Rd
Suite 101
Tucson, AZ 85711-2683
Phone (520) 694-5437

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064
  • Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L2258TXMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jul 30, 2008 Accepting new patients
Banner-University Medical Group Family Medicine CurrentSince Jul 30, 2008 Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1104886357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-648-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-648-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESE",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "L2258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.